Department of Health and Human Services

Office of Inspector General -- AUDIT

"Follow-Up Audit of the Medicaid Drug Rebate Program in Missouri," (A-07-07-03096)

February 7, 2008


PDF File Complete Text of Report is available in PDF format (396 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

Our objectives were to determine whether the State agency had (1) implemented the recommendations made in our previous audit of the Missouri drug rebate program and (2) established controls over collecting rebates on single source drugs administered by physicians.  We found that the State agency had established controls over collecting rebates on single source drugs administered by physicians.  However, the State agency had not covered all the weaknesses identified in our previous audit.

We recommended that the State agency (1) develop policies and procedures to reconcile the general ledger control account to the subsidiary ledgers/records and to the Form CMS-64.9R; (2) develop policies and procedures to identify the State agency’s dispute resolution process, including policies and procedures to offer a State hearing mechanism to manufacturers in order to settle disputes; and (3) determine the actual accounts receivable balance as of June 30, 2006, and amend the Form CMS-64.9R to include all outstanding rebate balances.  The State agency generally agreed with our findings and recommendations.